Basic Information
| Provider Information | |||||||||
| NPI: | 1003109448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUDATI | ||||||||
| FirstName: | GOKUL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10470 OLD PLACERVILLE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958272539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004700071 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 PLUMAS BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307495560 | ||||||||
| FaxNumber: | 5307495565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2011 | ||||||||
| LastUpdateDate: | 10/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2014022133 | MO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | RL11900 | ND | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A156322 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.